Method of producing artificial respiration.



R. S. PRINDLE.

METHOD OF PRODUCING ARTIFIC IAL RESPIRATION. APPLICATION FILED FEB. 10,1909.

1,169,995. Patented Feb. 1, 1911;.

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3:: we H1 07, Roscoeflfndudle By 7 I V 61m ncu R. S. PRINDLE. METHOD OFPRODUCING ARTIFICIAL RESPIRATION.

APPLICATION FILED FEB. I0, I909.

Patented Feb. 1, 1916.

3 SHEETSSHEET 2.

H. S. PRINDLE.

METHOD OF PRODUCING ARTlFlClAL RESPIRATION. APPLICATION FILED FEB 1Q,1909.

1,19 9% Patented Feb.1,1916. I

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P ineas,

UNlD STATES P =1 FFECE.

BOSCOE S. PRINDLE, OF NEW YORK, N. Y.

Specification of Letters Patent.

Patented Feb. 1, 1916.

Application filed February 10, 1909. Serial No. 477,03.

To all whom it may concern Be it known that l, Roscoe S. PRINDLE, acitizen of the United States, and a resident of the city of New York,borough of Manhattan, and State of New -York, have invented a certainnew, useful, and Improved Method of Producing Artificial Respiration, ofwhich the following is a specification.

Primarily my, invention" has to do with the production of artificialrespiration and the cure of tubercular disease, but in a broader senseit relates to the purification of the blood in the human circulatorysystem and the rehabilitation of the tissue of the human body.

My improvement in the art of healing such diseases and disordersconsists in substitut-ing external forces for or superimposing externalforces upon the habitual muscular movements of the patients thorax orchest and inso gaging or controlling these forces as to inflate anddeflate the lungs, first in rhythmic conformity with, and then, inexcess of, the patients normal breathing. The forces referred to arethose of gaseous pressure and a vacuum; and the aerating medium which Iuse is atmospheric air or mixtures of air and oxygen or othermedicaments as may best suit the condition and needs of the patient attimes of treatment. In other words, 1 supply compressed medicated ornon-medicated air to the lungs of the patient and then exhaust thelungs, using care at the beginning of the treatments to exactlyreproduce the patients breathing and afterward varyingand increasing theforces to cleanse the lungs and readjust the factors of inspiration andexpiration as rapidly as conditions safely permit.

My invention as more fully described hereinafter and as particularly setforth in the claims will be most readily understood by reference to theaccompanying drawings in which I have illustrated an apparatus suited tothe invention.

In these drawings, which form a part of this specification, Figure 1is'a diagrammatic view of apparatus adapted to the purposes -of my novelmethod or process of artificially producing, varying and controllingrespiration. Fig. 2 is an enlarged view of the mask which is applied tothe patients face, together with the automatic controller or valve. Fig.3 is a sectional view of the mask, on the line w, m of Fig. 2. Fig. 4 ising, or cooling flow of air may a sectional view of the mask, on theline 3 y of Fig. 3. Fig; 5 is an enlarged longitudinal section of thecontroller or valve, showing the parts in position to admit com-.pressed air to the lungs of the patient. Fig. 6 is another sectionalview showing how both the compressed air and the vacuum may be cut offand the patient supplied with atmospheric air at normal pressure; and,Fig. 7 is a sectional view on the line 2, z of Fig. 5.

I shall first describe the construction of the apparatus and will thendescribe the manner in which it is used in carrying out my invention.

Referring now to Fig. 1 of the drawings, A represents a source ofcompressed a1r, here depicted as a rotary compression pump which .issupplied with purified air, medicated air oroxygenated air from thebottles A A and A A is the air inlet. The air is filtered in the bottleA and passes thence to the bottle A which contains a quantity of liquidfor washing, and if desired, medicating, the air. When desired oxygenmay be admixed with the air in the bottle A by admission through thevalved connection between the bottles A and A the latter being an oxygentank. Then desired further apparatus may the aeratiing medium. The airin either medicated or non-medicated condition passes from the bottle Ato the pump A through the pipe A the regulating valve A The valve Aconstitutes the admission valve of the pressure pump, and by operatingthe same the second rotary pump B constitutes a source of vacuum, and Bis the discharge pipe thereof. This pipe delivers the impure air fromthe lungs of the patient to the washer or purifier B wherein the air iscleansed before being discharged at the outlet B For driving the pumps Aand B I employ a single electric or other motor C of approximately twohorse power. C represents a controller b which the speed of the motorand hence of the pumps may be widely varied and accurately controlled.

As before explained, in carrying out my rocess I successively inflateand deflate the lungs of the patient, and as the best means ofconnection with the sources of pressure and vacuum, I employ a mask D soconstructed that it may be tightly bound upon which contains be addedfor drying, heator packed against theface of the patient.

This mask is provided with inlet and outlet connections DA and DBrespectively ioined to the pressure pipe A of the pump A and the vacuumpipe B of thevacuum pump B. For convenience the parts B and A of thesepipes are made flexible. lhe rigid part of the pressure pipe A 'containsa manual regulating valve A and an automatic relief valve A Thecorresponding part of the vacuum 'pipe- B contains a manual regulatingvalve 13 and an automatic relief valve 13 The valve A is adapted to openoutwardly, while the valve B opens inwardly. Both valves are adjustable.By the use thereof constant pressure and vacuum in the respective pipesis insured. In this connection it should be understood that the pumpsare of somewhat greater capacity than actually required and throughthe-.medium of the controller C,

the manual valves A, B and the automatic valves A B the pressure and thevacuum at the mask may be regulated to any degree desired. Theregulating valves are entirely independent and the conditions of vacuumor pressure existing in one pipe may be altered without changing theconditions in the other. It follows that the operator has direct andpositive control and may vary both the'pressure and the vacuum at anytime notwithstanding the fact that the two pumps are coupled to a singlemotor.

For the purpose of alternating the appli vacuum I interpose thecontroller E between the pipes A, B and the mask D, and to avoid an aircushion between the two sources A and B and the lungs 'of the patient Iplace the controller- 'irectly upon the mask, making it a part thereof.The pipes A and B in a measure constitute reservoirs between the pumpsand the controller, and if desired actual enlargements or reservoirsmaybe provided in the respective pipes, though in practice I secure thebest results by limiting the capacities of the pipes to approximatelythe maximum requirements of a healthy person. A sputum cup EE isinterposed between the controller E" and the vacuum pipe 13 for thepurpose hereinafter described.

The controller E as herein shown is of a rotary type and for actuatingthe same and for adjusting its rate of action to correspond with thenatural respiration of the patient I employ a small'electric or othermotor F. The connection between the rotary member of the controller andthe motor is established through the speed reducer F and the flexibledriving shaft F F represents the controller of the motor F by which thespeed of the fiexible'shaft F may be varied within the range of fromfive to fifty revolutions per minute. An indicator I and a counter F 5enable the operator to exactly adjust the speed of the respiratorycontroller E.

For securing pressure and vacuum readings; I employ a U-shaped mercurytube G, ofwell known construction, coupled to the pipes A and B .bysmall pipes G and G and having selective valves G and Gr.v Slightvariations of pressure take place be tween the regulating valves A l3and the mask, and in order that the actual conditions within the maskmay be known I preferably'employ a second mercury column H, and aspirometer or volume meter I, temporarily connecting them, whenrequired, to the mask by the flexible tube It, and the valve or cockH,whichlatter is a perma-' nentpart of the mask..- As hereinafterexplained I also employ both' the pressure meter '11 and the volumemeter I, in determining the condition of the patient prior to and aftertreatment.

The details of the mask and the controller. are best shown in Figs. 2 to7. As there shown the mask is approximately conformed to the face of aperson and is of sufiicient size to cover the forehead, cheeks and chin.This mask is secured to the head by straps D, and as a convenient meansof closing the joint between the mask and the face, I employ in theformer a pneumatic tube or packing D This tube extends around the rim ofthe mask and when the latter has been strapped upon the patients headthe packing tube is inflated, through the valve D to the extentnecessary tocause it to conform to the bony structure of the face andtightly'close or seal the mask; to prevent the escape of compressed airtherefrom or the entrance of air at the rim of the mask when a partialvacuum is established therein. An advantage attaching to this particularformation and construction of the mask is that the chin, lips, nose and,eyes of the patient are left free and circula tion in the facial skinand muscles is not m terfered with. Aside from the mechanical features,my primary object in the use -of the mask is to distribute the pressuresand equalize the same upon the face of the patient and the several ductsand organs which terminate in the mouth, nasal passages and eyes. Insome instances I employ pneumatic ear stops on the mask and incommunication therewith, the same flexibly ]O1I11I1g the mask to theears of the patient and having the effect of balancing the pressures inthe eustachian tubes. D*, D are eye glasses in the front of the maskthrough which the patient can see what is going on around him. That partof the mask which is opposite the lips contains a cavity or pocket B toreceive the sputum. The vacuum passage D leads from the bottom of thiscavity. The compressed air passage D is arranged in, and opens throughthe inner 'troller E is shown below wall of the mask; at a pointconsiderably above the pocket D to prevent sputum from entering it.

For convenience of illustration the conthe maslnbut I prefer to moreclosely assemble these parts, and in practice find it desirable to placethe valve casing either directly in or against the lower part of themask. As herein shownthe ofiset portion D of the mask, which containsthe ducts D and D is provided with nipples and union joints D forconnecting them to the casing of the valve or controller.

The automatic admission and exhaust valve or controller E, best shown inFigs. 5, 6 and 7, comprises a cylindrical casing E and a cylindricalvalve member or plug E The top of the casing contains ports a and bwhich communicate with the ducts l) and D respectivelythroughtheconnecticns D and D respectively. The lower part of the casingcontains ports a and b to which the pressure and vacuum pipes arerespectively connected by the nipples A and B The port a is preferablyan annular groove in the inner wall of the casing, and parallel withthis is another groove E which communicates with the atmosphere throughthe hole E The grooves or ports a and E are separated by a narrowannular partition E It will be noted that the ports a and a arerelatively staggered; this is true also of the ports 6 and b. The valveproper or plug is divided into two chambers (1. and b by the middlepartition E and the end plugs E and E At the air entrance end, the partE is provided with a small port a and also an elongate port a whichports are relatively staggered, so that the port (2. co-acts only withthe port a. The port a" is adaptedto co-act with the port a and alsowith the port E as hereinafter explained. At the vacuum end of thevalve, the member E contains'the staggered ports Z) and b which co-actrespectively with the ports 7) and I). As shown, the flexible shaft F isjoined to the outer end of the valve member E and by means thereof theplug is regularly rotated, to alternately open and close the air andvacuum passages. /Vhen the passage through a, a, a, a and a is open, thepassage through 1;, b bib and b is closed, and vice versa. Both passagesare never open at once, though the interval between the opening of oneand the closing of the other is comparatively short, the intervalsconforming to the ratio of lapse and recovery in a persons breathing.The plugs E and E are longitudinally or revolubly adjustable in thevalve member E and by means thereof 1 am able to so change the shapesand dimensions of the ports a) and b as to accomplish a definite andexact imitation of the cadences of a patients breathing. It will benoted that these adjustments are wholly independent; this beingnecessitated by the fact that the cadences of inspiration and expirationare rarely the same.

The valve member E is longitudinally movable in the casing. Stops E andE limit its movement. The latter is adjustable on the end of the memberE and is preferably in the form of a hand wheel by which the valve maybe manually turned, for purposes of experiment. I A spring E between theend of the casing and the stpp E serves to hold the valve in theposition shown in Fig- 5, but by pressing on the end of the valve eitherthe operator or the patient may instantly shift the valve andOPBIhdlI'QCt communication with the atmosphere through the ports E a anda, as shown in Fig. 6, at the same time closing both the air and vacuumpassages. A latch E serves to hold the valve when thus shifted until itis desired to resume treatment.

The construction of the apparatus, which is a desirable aid to theproper use of my invention, being now understood, I will now describe mynovel method or process in detail.

When a patient presents himself for treatment 1 first ascertain hisgeneral condition, particularly the state ofthe lungs, and carefullymark and determine the periodicity, cadences, volumes andsp ressures ofthe inspirations and expirations. The periodicity and the cadence may bemechanically determined by the use of suitable apparatus, but as thesounds of respiration are clearly perceptible, and as the respiratoryapparatus herein shown emits like' sounds, it is an easy matter toadjust the latter to correspond.

This adjustment is secured, as to periodicity,

by regulating the speed of the motor F; and, as to cadences ofinspiration and expiration, by adjusting the valveports a. and I)through the medium of the i'po'rtage regulators or plugs E and E Iemploy the pressure meter H and the volume meter 1, in determining thepressure and the volume of the patients breath, and then exactlyreproduce these factors by regulating the speed of the pump motor C, theinlet and outlet valves of the pump, and the relief valves A and 3Having then quite accurately "adjusted the pumps and the several valvesand the controller-valve operating motor, I preferably subject theapparatus to a final test by closing the back of the mask and takingreadings therefrom by connecting the meters 1 and H thereto. Having nowadapted the apparatus to the exact or substantially exact reproductionof the patients natural or normal respiration, I apply the mask. Thismay be done without stopping the apparatus if the valve E is moved tothe open atmosphere shown in Fig. 6 of the drawings.

' pocket D When the mask has been properly adjusted the treatmentproceeds, being instituted by the restoration of the valve E to workingposition; after which, each revolution of the valve causes the'lungs ofthe patient to be successively inflated and deflated. It will be obviousthat by thus alternately forcing aerating medium into the'lungs of thepatient and exhausting the lungs, he is relieved from both voluntary andinvoluntary muscular effort and ,is at once placed in a condition ofrest. As the treatment proceeds the patient receives the benefits of afuller and more regular oxygenation of the blood and the 'efi ective andregular exhaust and ejection of both accumulated and accumulatingcarbonic acid gas. The removal of the latter is final, reentrancethereof to the lungs being absolutely prevented; which is rarely thecase, even when breathing in an open atmosphere. The regular tides andimpulses, which I-am thus able to "set up in the lungs of the patient,displace the'obstructions therein and cause the sputum and virus namely,the pressure and vacuum, also the volume of air administered, and varythe periodicity and cadence, with view to establishing greater lungcapacity and better breathing conditions; to inculcate also, the habitof deep breathing and the desire for purer air. At different times, whenthe accumulation of exudate in the lungs requires such treatment, todislodge and eject it, I

reduce the portage of the vacuum passage by means of the plug E andincrease the vacuum by adjustment -of the valves B and B therebyincreasing the force of expiraor time, i which are in the nature ofcoughing; by

tion or deflation, but shortening its period and thus produce repeatedactions which the patient is effectually relieved of deleterious fluidsas well as gases.

As various modifications of my invention will readily suggest themselvesto those who are skilled in the art and its practice, I do not limit orconfine my invention tcthe specific steps herein defined, nor in theuses stated, or the apparatus herein disclosed.

Having thus described my invention, what I claim as new and desire tosecure by Letters Patent, is:

1. The method of producing artificial res piration which consists inperiodically inflating the lungs of the patientwith suitable aeratingmedium and alternately deflating the lungs, both in substantialconformity with the periodicity, cadences, volumes and pressures of thepatients normal breathing, and from time to time varying the severalfactors, to expedite the ejection of deleterious gases and substances.

2. The method of producing artificial respiration which consists inalternately inflate ing the lungs of the patient with aerating mediumunder pressure and in'shorter alternate periods forcibly withdrawingsaid medium from the lungs and thereby withdrawing fluids therefrom. p

3. The method of producing artificial respiration which consists inperiodically inflating the lungs of the patient with a suitable aeratingmedium and alternately defiating the lungs, first in substantialconformity with the periodicity, cadences, volumes and pressures of thepatients normal breathing, and gradually increasing the intensity of theseveral factors to expedite the ejection of deleterious gases andsubstances. In testimony whereof, I have hereunto set my hand this 9thday of February, 1909, in the presence of two subscribing witnesses.

I ROSCOE S. PRINDLE.

Witnesses:

CHARLES GILBERT HAWLEY, N. CURTIS LAMMOND.

